Kawarada Osami, Noguchi Teruo, Yasuda Satoshi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
Cardiovasc Intervent Radiol. 2018 Feb;41(2):313-316. doi: 10.1007/s00270-017-1780-4. Epub 2017 Aug 30.
To report a percutaneous intravascular cracking with a guidewire tail (PICKING) technique to longitudinally crack the underlying calcification and facilitate the balloon catheter passage for the treatment of severely calcified chronic occlusions in the infrainguinal artery.
Three patients underwent PICKING technique between November 2014 and March 2017. The PICKING technique with the stiff tail of 0.018-inch guidewire in the straight configuration was considered in cases of failed passage of the smallest balloon catheter because of the underlying severely calcified occlusion following passage of 0.014-inch guidewire.
All three patients were complicated by end-stage renal disease on hemodialysis. Treated vessels were superficial femoral artery in two cases and anterior tibial artery in one case. In all cases, successful passage and dilatation of the balloon catheter were achieved, and significant improvements in clinical symptoms were observed following subsequent optimal balloon angioplasty or stenting.
The PICKING technique could increase the potential of endovascular solution for the treatment of severely calcified chronic occlusions in the infrainguinal artery.
报告一种带导丝尾端的经皮血管内破裂（PICKING）技术，用于纵向破裂深层钙化，促进球囊导管通过，以治疗股下动脉严重钙化慢性闭塞病变。
2014年11月至2017年3月期间，3例患者接受了PICKING技术治疗。对于在0.014英寸导丝通过后因深层严重钙化闭塞导致最小球囊导管通过失败的病例，考虑采用带有0.018英寸直形导丝硬尾端的PICKING技术。
所有3例患者均合并终末期肾病并接受血液透析。治疗的血管2例为股浅动脉，1例为胫前动脉。所有病例均成功通过并扩张了球囊导管，在随后进行最佳球囊血管成形术或支架置入术后，临床症状有显著改善。
PICKING技术可提高血管内治疗股下动脉严重钙化慢性闭塞病变的可能性。
